Ask the Nutritionist: How Does Diet Affect Psoriatic Arthritis?

1. Is there a link between diet and psoriatic arthritis?

The risk of developing psoriatic arthritis (PsA) is strongly influenced by genetics, but it’s also higher among people who are obese. Dietary changes for weight loss and weight maintenance can reduce the risk of developing the condition. They can also impact the expression of the genes associated with PsA.

A healthy diet can also significantly affect the level of inflammation in your body and help you better manage pain.

2. How can a nutritionist help me with my psoriatic arthritis?

A nutritionist or registered dietitian nutritionist (RDN) can tell you how dietary changes can help your PsA. They can also explain the underlying inflammation driving your condition.

They’ll collect a food recall and dietary history to determine your baseline diet and food preferences. This may also include a nutrient analysis to determine if you have any nutrient gaps in your diet. They’ll also review your lab work.

From this, the RDN can help create a plan with short-term and long-term goals, foods to include, foods to exclude, and recommended supplements. They can also provide resources like meals plans, recipes, and more.

An RDN will recommend regular follow-up appointments to support you as you make changes over time. Depending on your individual circumstances, these appointments may occur every two to six weeks.

3. What foods do you recommend for people with psoriatic arthritis?

Recommended foods include those that reduce the body’s inflammatory response. For example, foods high in omega-3 fatty acids can help, such as:

Also, colorful vegetables and fruits can help, especially dark green, orange, and red foods. These should form the foundation of your diet. They provide nutrients to control inflammation and reduce oxidative damage to cells.

You should also avoid processed meats made with a high heat cooking method like roasting or grilling. This can form advanced glycation end products (AGEs), leading to accelerated inflammation.

Some people with PsA may also benefit from limiting carbohydrates. For example, you may want to follow a ketogenic diet or avoid gluten and dairy. But there isn’t much research that limiting carbs helps specifically with PsA.

You may also want to try an elimination diet that excludes the above foods for four to six weeks. It can help you determine if your condition improves with these dietary changes.

5. Are there any supplements that are helpful for psoriatic arthritis?

Several supplements may be beneficial in controlling inflammation, immune function, and pain. Examples include:

turmeric

vitamin D

fish oil

bone broth or collagen protein

Vitamin D supplementation is especially important if your baseline vitamin D is deficient.

Research shows a clearer link between inflammation reduction and fish intake. But fish oil supplements, especially in the phospholipid form, may also provide benefit to some.

Curcumin is the main active ingredient in turmeric. Research supports its role in reducing pain and inflammation.

6. Where can I find a nutritionist?

Ask your doctor if they can refer you to a dietitian or nutritionist. You can also check with your insurance company, as some dietitians in your area may be designated as in-network providers.

Other ways to find a nutritionist or RDN include asking friends and family for recommendations. You can also search online for local dietitians or ones who are familiar with inflammatory conditions. Many dietitians also offer long-distance consultations and programs.

7. Is it OK to drink alcohol when I have psoriatic arthritis?

Alcohol is typically not recommended if you have PsA because it has been associated with flare-ups. It also may interfere with the effectiveness of certain medications, such as methotrexate.

Alcohol is also a common source of extra calories that can lead to weight gain. It depletes nutrients in your body during the metabolism process. It can also result in poorer food choices, which further worsens your nutrition status.

8. What should I look for on nutrition labels?

Look at the ingredient list first. If it’s long, difficult to understand, and contains ingredients you wouldn’t have at home, look for a cleaner alternative.

On a nutrition fact panel, pay attention to sodium, saturated fat, and sugar content. A high sodium diet can worsen swelling and increase pain.

A diet high in saturated fats may worsen inflammation and overall health. This means greater than 10 percent of calories in saturated fat grams, or more than 20 grams for a 2,000 calorie diet. Sugar intake of more than 24 grams per day for women and 36 grams per day for men can lead to weight gain, inflammation, and poorer nutrition status.

The healthiest foods often don’t come in packages with nutrition labels, or they have minimal ingredients. This includes eggs, nuts, whole fruits and vegetables, fish, plain yogurt, dried beans, and olive oil.

Natalie Butler, RDN, LD is a holistic and functional medicine-based registered dietitian nutritionist. She has expertise with a variety of diets and diseases, especially inflammatory and digestive conditions. Natalie founded her own practice, Nutrition By Natalie, in 2007. She is currently a wellness dietitian for Apple, Inc., a medical reviewer for Healthline.com, staff dietitian for SuperFat, an advisory board member for Head Health, Inc., and supports various other organizations and individuals through her consulting services.